This may seem a strange charge to lay at the door of our notably technophiliac (when he doesn’t have to use it himself) Prime Minister but I’m going to make it anyway.

I accuse Tony Blair of sqaundering the potential benefits of information technology, in the House of Commons, with the Database.

Rest assured, this not a post about the general incompetence of the public sector when it comes to the commissioning and development of information technology projects - although one could write several books on that particular subject and not run short of source material - but about public perceptions of the use of technology by the state that have be largely generated by the Maximum Tone’s twin-linked obsessions of control and modernity.

Let me permit the good Dr Crippen to pick up the story…

Dr Crippen, and many other medical writers, have been warning patients for over a year of the dangers of the government insistence that all private medical records should be on the government central computer, eerily known as “The Spine”.

Doctors are now being asked to supply the names and addresses of patients who have “genuine” reasons for not wishing their records to be stored on the government’s centralised computer. These recalcitrant trouble-makers will then be rounded up and taken to a secret location in North Wales for “retraining”.

Do not be silly, Dr Crippen. This is not Stalinist Russia. This will not happen. For, you see, there are no genuine reasons. The medical commissars want…

...the names and addresses of objectors in order to write to them to tell them that their request would not be granted because their reasons were not “genuine”.

Dr Crippen is certainly not wrong to voice his concerns, nor to take Sir Liam Donaldson, the government’s Chief Medical Officer, to task for his request for the names and addresses of refusnik patients, but he is wrong about ‘The Spine’…

…or rather he should be.

The underlying principle behind the NHS ‘Spine’ is a good one.

By computerising key information about patients of the kind that may affect or impact on their medical care, should they be taken ill or injured ‘out of hours’ or away from their home area and making this information readily accessible to doctors in, for example, A&E units, the summary care records held in The Spine could, quite literally, save lives (and money, as well - but that’s another story).

The NHS’s ‘Connecting for Health’ website lists the kinds of information that The Spine is intended to contain:

Your NHS Medical Number (obviously, so they can identify your summary care record).

Your Date of Birth, Name and Address (again, so they can be sure that they have the right records).
Any known allegies or adverse drug reactions.

Any major treatments that have been provided in the past, are continuing or have been completed.

And that, according the website, is it, even though, if anything, there would appear to be additional items of basic information that probably should be included, but aren’t - blood group and any medication currently prescribed to the patient would seem to be the main omissions, unless these are covered under the definition of major treatments.

The NHS Spine is not intended to carry patient’s entire medical records, merely a summary of useful information - the full records are dealt with under a linked project to develop full electronic care records for all patients, with those records to held locallly and not not on a national database.

Now, there are are two other ‘features’ of The Spine that need to be considered.

First, what is its stated purpose?

Well the website tells us this, in something that vaguely resembles English:

The Spine’s objectives are to:

improve patient experience at all stages of care from initial contact, through referrals, to scheduled treatment and back to home

reduce the fragmentation of care caused by inconsistent systems and records

improve the quality of care by setting standards across clinical and social care networks

enable effective access to clinical and administrative information across care providers and locations to support the NHS

develop policy and research through improved and more accessible data.

And to top it all off, we’re told that:

The most rigorous controls will put in place to ensure the privacy of information and people, in discussion with their doctors, can decide what will be visible in their Summary Care Records. A service called Healthspace will enable people to access their own records 24 hours a day so that they can see the information and can check for errors. These are the first steps toward giving people greater access to and control over their health information.

Now I’m not a doctor, but I am a techie (amongst other things) and understand how information systems work, and on a technical level, everything listed here is certainly possible and within the capabilities of current technology. Incompetence of execution notwithstanding, it can be done.

But then I also have to ask myself, is this really the kind of system that doctor would want? Such a system could deliver many benefits to the medical profession and improve patient care - which is what’s its all about in the long run - but then one also has to ask whether such a system might look rather different had it been designed by doctors, and if so, in what ways would it differ from the government’s proposals.

Let’s start with a simple proposition.

The Spine and the information it contains will be most useful/valuable at the ’sharp end’ of medical care, i.e. in situations where a patient presents themselves to a doctor or in brought in for treatment and the patient is more or less a complete unknown.

Yes, we’re back, again, to our hypotheticial hard-pressed and desperately overworked A&E medic, who in many cases, especially when faced with a patient who is unconscious or incoherent, would probably give their right arm for rapid access to basic medical information about the patient in front of them. With routine appointments of the ‘we’ve booked you in with a consultant in a couple of weeks time, Mr Smith’ the ability to move information quickly from A (the patient’s medical records) to B (the doctor) is not really a factor. But when A, in unconscious, having collapsed in the street, and B, is an working in an A&E and trying to save A’s life, then the more relevant information you can get to B, as quickly as possible, the better A’s chances are likely to be.

What doctor’s working at the sharp end of emergency medicine want is fast access to information about the patient in front of them that may be relevant to or assist with making an accurate diagnosis and determining the right treatment to administer.

Or, simply, they want a system that will help them save lives. And by no great coincidence, that also tends to be the kind of thing that the general public wants, just in case they ever find themselves in position B.

How does this translate to the objective listed above?

Well, for starters, ‘enable effective access to clinical and administrative information across care providers and locations to support the NHS’ is obviously relevant. No its not just relevant its axiomatic - if the system cannot do this one simple task then it serves no purpose whatsoever.

‘Reduce the fragmentation of care caused by inconsistent systems and records’ also seems to be a good one. It would be nice to think that one would get broadly the same standards of care whichever A&E unit you end up in and this is obviously not going to possible if the only unit with access to your records is your local one and you’re taken ill or injured while away from your local area.

So far so good…

Then there’s ‘improve patient experience at all stages of care from initial contact, through referrals, to scheduled treatment and back to home’ - okay, perhaps, but only in the case of initial contact is rapid access to information sufficiently critical as to require a central national database, so we’re stretching things here.

And while ‘develop policy and research through improved and more accessible data’ is a nice thing to be able to do, that’s strictly speaking only a byproduct of having this kind of information system, not a primary objective, which leaves only, ‘improve the quality of care by setting standards across clinical and social care networks’.

No, sorry, can’t quite what that has to do with our hypothetical ‘Emergency Medic’ scenario. Standards may well have their in the grand theme of things, but I’m rather more interested in how this will all help our hypothetical doctor get one with doing what he (or she) does best, some actual ‘doctoring’.

Does it not strike you as just a little strange that nowhere in these objectives does it state, clearly and explicitly, that the single most obvious and fundamental purpose of this system is to provide doctors with information about patients that contribute to saving those patients lives?

Am I just being a bit too obvious here, or is that not the primary function, purpose and raison d’etre of the medical profession - in which case you might think that this should be acknowledged.

Okay, so the press release is rather better, inasmuch as it does state clearly:

The summary care record will provide basic information to anyone in England treating patients out of hours, in an emergency or away from home. It will ensure they receive quicker and safer care.

Thank you. Now why could you not just have said that in the first place!

This kind of thing in entirely symptomatic of the government’s attitude and approach to the use of information technology in the public sector, and its this that more than anything else, even the abject incompetence of its commissioning processes, that is eating away at public confidence.

What doctors, and other medical professionals, actually need from a central NHS information system is very simple; fast access to reliable, accurate and relevant information that assist them to fulfil their primary purpose, treating patients.

In the case of patient medical records such a system should simply deliver information from the patient’s ‘file’ to a properly accredited medical professional on presentation of the necessary electronic credentials to authorise their access to this information. As long is this information is stored securely and properly classified and tied in to an appropriate access control system such that, depending on the credentials presented, the user is provided with access only to those portions of a patient’s file that it is necessary for them to access to carry out their job, then the system should function very well.

This is not, in terms of information technology, complicated stuff - it’s bread and butter data processing, as long as you’re clear as to your primary purpose and build your system accordingly.

You need a closed network that’s not exposed to the internet and all those nasty hackers. You encrypt all data stored on the system and all traffic across the network. You deploy both physical and electronic security measures - to access the system you have to use a PC that’s connected to it, supply a user name and password and supply physical verification of your ‘indentity’, which could mean anything from a chip and pin card to biometrics. You store the bulk of the data locally, maybe not at GP surgery/Health Centre level, but nothing in scope larger than a PCT or other Healthcare Trust and you employ ‘redundancy’ - which has nothing to with sacking people, all that means that you don’t put all your eggs in one basket or your data on one site, you have a master data store and one or more backup systems that kick in if the master fails for any reason, and because you have more than one data storage system, you can also automatically cross-reference them in order to find and correct data errors.
Any IT professional reading that will tell you right away that, give or take the biometrics, everything described above is easy - all you need is common data standards and protocols so that the PC in the A&E department in Brighton talks the same ‘language’ as the data store in the patient’s home area, which could be anywhere in the UK, and Robert, as they say, is your mom’s brother.

Do you need a national database is such a system? Only in a very limited sense, as a master index to enable you to locate the information you need, but for the sake of speeding up the retrieval of information in emergencies, you’ll get some benefits from tacking on a summary record of key information on to the national index, which give you your NHS spine.

What matters most in all this is not where your data lives, physically - this website you’re reading now is physically located in the US, but unless you went to soem trouble to trace its location, you wouldn’t know that unless I told you - which I just did.

What matters is how your information in controlled and managed, and more importantly by whom - who, if you like, is the custodian of your information.

And that can remain as it always has been, your GP, who decides what information should be recorded on your file, how it should be classified - within the parameters of a recognised system used by all medical professional , etc.
And when it comes to your summary record, its your GP who can decide what information from your full records should be included on the summary on the basis of their knowledge, experience and expertise as a doctor - who else is better placed to decide what information from a patient’s file might be useful or relevant to out hypothetical A&E doctor than another doctor.

And if that were not enough, because you have system devised and designed by doctors for use (primarily) by doctors, you have a system that’s also governed by good old fashioned medical ethics.

‘Selling’ a system like that to the general public would be, for the most part, a doddle - you’ll always get a few people who don’t trust technology at all. Why? For two reasons.

First, although the way patient records are stored and accessed has changed mssively, the way those records are managed and controlled, hasn’t. The same people (doctors) that the public have trusted to look after their medical records since the founding of the NHS are still in charge and running the show.

Second, and more importantly, such a system has a clear purpose and purpose that is unmistakably in everyone’s interests. In an emergency, getting the right information to the right person at the right time could help to save your life - what possible argument could be more compelling than that.

But that’s not what the goverment wants. It’s not content with a system that does a clearly defined and beneficial job, what it wants as well is a system that will enalbe bureaucracts to set targets, finance directors to allocate budgets, policy wonks to write policies and protocols and auditors to monitor standards.
Now many people may not understand the technology, but they do understand that when you start tacking the bureacracy on to the system, that means a whole lot of people who aren’t doctors getting the grubby little managerialist paws on their personal, confidential, information - and if people that like are suddenly to be included in the information loop then just exactly who else might worm their way into the system in future? The Police? Insurance companies? Employers?

It’s not necessarily hackers you need to be concerned with, in fact the quickest way to circumvent that issue is to cast around, find the best available and give them a job testing and validating the security on your system - ‘it takes a thief to catch a thief’ as the saying goes - but all those other functionaries, policy wonks and bureaucrats who’ll suddenly that they have a reason to access your data as soon as its all safely tucked up somewhere that’s relactively easy to get to, as long as you’re inside the system.

And so, a project that should accrue near universal support from the general public, if only its kept simple and directed to delivering genuine and worthwhile benefit to patients, suddenly becomes controversial and starts spawning refusniks all over the place - and with that they disappears just that little bit more trust in the beneficial potential of information technology and its use for the public good.

One can see the same thing taking place in relation to Identity Cards and the National Identity Register.

A national identity card that simply verifies that you are who you say you are, but that leaves you in control of how its used and what, if any personal information, might be disclosed when you use it would still be a bit controversial, but only because as a nation we have a marked historical aversion to such things. But it would nowhere near as controversial as the leviathan, with its all consuming database system, that the government is trying to foist upon the British people.

Such a system is entirely possible - it would be based on a principle called ‘zero knowledge proof‘, and a system contructed on this basis would be simple, straightforward and reasonably cheap to deliver - give or take the use of biometrics (again).

But, again, that’s not what the government want - what they want is system that will fight crime, secure our borders, catch terrorists and deport illegal immigrants. The fact that we have all those things already; they’re called (respectively) ‘Police Officers’, ‘Passports’, ‘MI5′ and ‘Immigration Officers’ is immaterial, because somewhere along the line a technofetishist policy wonk has told the Maximum Tone, a rarity of a man who combined both abject technical incompetence with extreme technophillia, that all this is a good thing and will do wonders, solve the problems of the country and, probably make the tea as well - and Tony believes him.

Why? Not because Tony understands but because ‘modern’ is Tony’s personal crack cocaine and someone’s told him all this is modern.

Information Technology can be, and should be, a force for social good, just so long as you remember always who’s the master (people) and who’s the servant (technology) but it can also be a mechanism of control, an overlord and a tool of the autoritarian state. Much the same as governments then - and it should, therefore, be no surprise to find the Maximum Tone slowly, and systematically, destroying public confidence in both and killing his own golden goose in the process.

Meanwhile, if you head down into the deepest recesses of Whitehall and look very carefully, you find the techies who’ve been filling the Maximum Tone’s head with all thise strage ideas, scurrying around like and tittering to the themselves a la Beavis and Butthead as they chant their favorite mantra.

“I bet we’ll get a nice fat pipe out of this project”

There’s been a couple of noteworthy responses to Mr Eugenides fisking of Polly Pot’s recent Blairite love-in that, in turn, deserve a response.

Tom, at Let’s Be Sensible, seems to be trying to be, well, sensible in taking issue with Mr E’s humourous commentary on vegetable masturbation and proves…

…well only that tastes vary.

Like so many oither things in life, humour is in the eye of the beholder - either you find Mr E’s depiction of Polly Pot fantasising over Gordon Brown while masturbating with a carved organic carrot purchased from Tesco, or you don’t, in much the same way that some people find Richard Pryor hilariously funny, while others prefer the Chuckle Brothers, at least until they’re served with an order under the Mental Health Act.

Elsewhere, Pootergeek takes Mr E to task for pulling apart Polly’s use of logical fallacies and then throwing in one of his own…

What case does Mr E offer in reply? The “what if a bad government took control?” one. Yep, a fallacy so limp that no one can be bothered to give it a fancy Latin name (though I’m happy to be corrected).

Someone better versed that I could probably put an exact name to the fallacy that Pootergeek claims on Mr E’s behalf, which would certainly fall within the bounds of an appeal to consquences (argumentum ad consequentiam to give it its fancy latin name) with shades of an appeal to probability and a hefty dose of both misleading vividness and a parade of horribles - the outcome of introducing ID cards, that is, not Mr E and Pootergeek.

Aside from noting that Pootergeek wanders right into a logical fallacy of his own by framing much of his critique in the form of an appeal to ridicule - humour invariably entails the use of fallacy, in the form of exaggeration and hyperbole, and is therefore best avoided as a counterargument to another fallacy - he also makes a few assertions that don’t really stack up when looked at seriously, for example:

it’s partly because the supposed civil liberties arguments are so shockingly feeble and so poorly made that Tony Blair can get away with backing a centralised database of citizens on the grounds that it would be more “modern” to have one than not to.

The civil liberties arguments in relation to ID cards are certainly not feeble but they are complex and problematic in the sense that one is dealing first with an abstract concept (civil liberties) and second with a situation in one is required to exercise soem predictive judgment in suggesting both what consequences might flow from their introduction and whether those consequences should be thought of as either good, bad, or a mixture of both.

This creates a problem in that it tends to encourage arguments that rapidly degenerate into an exchange of fallacies - those arguing against their introduction resort to the much discredited ’slippery slope’ line of argument against which their supporters will usually wind-up throwing in the ‘no true Scotsman’ fallacy in the form of ‘no democratic government would ever…’.

Neither is entirely correct.

Slippery slopes tend to rely heavily on painting scenarios which offer the worst possible outcome, as in the classic canard that suggests that legalising gay ‘marriage’ will lead to the end of civilisation as we know it. If you want to see the slippery slope argument in action, just pop over to Mad Mel’s as it a standard feature of almost all her output. It is also equally fallacious to suggest that just because something hasn’t already happened it can’t or won’t happen, which is the general gist of the argument deployed by supporters of ID cards.

Nor, however, is either entirely incorrect, either.

Slippery slopes can, on occasion, come to fruition - hence Pastor Neimoller’s oft quoted statement that begins, ‘First they came for…’ and if they don’t, then quite obviously the position of those who argued that the sky isn’t going to fall is vindicated.

The civil liberties argument in relation to ID cards is, consequently, not ’shockingly feeble’ but requires a complex value judgment as to the consequences that will emerge, if any, as a result of their introduction, one that requires serious and careful contemplation if one is to arrive at any valid conclusions.

That Blair is able to deploy the argument that we should introduce ID cards purely because they represent modernity is not a function of the weakness of civil liberties argument but of a more general malaise that afflicts British political and media culture as a whole. Over the last 30 years or so, under first Thatcher and latterly Blair, Britain has developed an attention deficit political culture in which large swathes of the population have been conditions by both politician and the media to expect and respond to certain things either postively or negatively.

Strong leadership, party unity and simplistic solutions that promise immediate action (i.e. dog bites child therefore ban all dogs) have been relentless promoted as ‘good’, while debate, dissention, argument and complexity have been pushed as being ‘bad’.

To consider, fully, the civil liberties implications of introducing ID cards requires one to consider a whole raft of complex issues and possibilities with due reference to extant historical precedents, which in many instances are the best we have to go on in trying assess where prevailing trends in government may lead, a process that is the antithesis of the prevailing political and media culture, which values, instead, the immediate gratification of a conditioned Pavlovian response to propaganda in the form of soundbites.

Notwithstanding the legitimate civil liberties objections one can raise against ID cards for which there are strong historical precedents - and it should be noted that this includes pointing out that direct comparisons to countries such as Sweden, France and Holland are wholly invalid not only because none of those countries back up their own use of ID cards with anything like the all-encompassing database system that will sit behind the UK’s system but because of fundamental differences in legal culture between common law and civil code countries - perhaps the single greatest argument in favour of extreme caution is simply that the vast majority of the British population do not sufficiently understand the issues, as they arise out of ID cards and the development of what has been called the ‘database state’ and the ’surveillance society’ to genuinely make informed choices as to how far, and and what pace we should proceed down that road, if we should go there at all.

One of the signature characteristics of the ID cards debate over the last two years or so is that the govenment has consistantly both relied on deception and refused outright to engage in meaningful debate with the schemes opponents on any complex issue, whether this the potential impact on civil liberties or simply the question of costs. Throughout, its stock response to any awkward or problng question has been simply to announce that it either rejects the view of opponents outright or refuses even to recognise the arguments.

In such circumstance, when a government refuses to enter into open public debate on legislation it is seeking to pass, the only wise, sensible and prudent response is not to permit them that legislation.

Every so often one finds a politician making a comment or statement in which something causes you to pause for a second and say to yourself, ‘just what, exactly, are they actually saying here?’

Such a statement can be found right at the beginning of Tony Blair’s recent attempt to sell ID cards to the readers of the Telegraph, which he opened with the following statement:

On any list of public concerns, illegal immigration, crime, terrorism and identity fraud would figure towards the top. In each, identity abuse is a crucial component.

All of which looks straightforward enough and nothing more than the usual govenrmental rhetoric of the day, until one looks a bit more closely and notice that he refers specifically to ‘identity abuse‘. What a curious turn of phrase - not identity theft or identity fraud, which one might expect, but identity abuse. What, one wonders, is it that he’s actually referring to in using that specific phrase and how, exactly and in what context, does one abuse identity?

Looking at Blair’s list of public ‘concerns’ (and disregarding the reference to identity fraud as a tautology) each of the three remaining issues; illegal immigration, crime and terrorism are certainly fields in which the fraudulant use of identity may feature. When one could say with certainty that it is a crucial component is somewhat more open to question.

One can certainly enter the UK illegally and subsist in UK society without the need to make use of a fradulent identity if one is prepared to avoid all normal ports of entry and make ones living in the ‘black economy’ - indentity is a factor in illegal immigration only if one seeks to seeks to enter the country by legal channels, albeit on the back of having provided false information, seeks to avail oneself of public services or employment opportunities, which require you to interact with the state or, of course, in seeking to evade capture and deportation but it does not follow that questions of identity will arise in all instances of illegal immigration.
The same can be said of crime. There are crimes in which identity is a factor and use of a false identity central to the crime itself, but many more in which is no particualr relevance at all, except in the context of evading the attentions of the police. And when one comes to consider the question of terrorism, the question one has to pose is that of which is actually the more important, the concealment of the identity of a putative terrorist or the concealment of their intent, preparations and activities?

False identities may, for example, help to facilitate activities that support and sustain terrorism, such as money laundering, but even there its questionable as to the extent to which such activities rely on the fraudulent use of personal identity as opposed to, for example, the fraudlent use of a business identity such as a ‘financial shell’ to conceal the nature of the transactions not the identity of those carrying out the transactions.

It is also the case, particularly in relation to illegal immigration and terrorismm where the putative terrorist is not a UK citizen, that while the individual(s) in question may have supplied a false identity to the UK authorities, the documentation provided in support of their claim to a particular identity may well be entirely genuine as a consequence of the primary fraud having been undertaken elsewhere, as happens where ‘false’ (as in innaccurate) but otherwise legitimately produced identity documents are obtained by way of the bribery of public officials.

For each of Blair’s non-tautological exemplers, the use of false or fradulent indentities may be a factor or they may not - none is entirely contingent on identity fraud in order to function noe, necessarily, sufficiently contingent on it to merit referencing it as a crucial component of such activities.

Can we infer, from any of this, precisely what Blair may have meant when he referred specifically to identity abuse? I think we can.

In referring to identity abuse, Blair is referring not simply or exclusively to the fraudulent use of identity but more globally to any situation in which an individual seeks to conceal their ‘true’ identity from the state irrespective of their reason or purpose in doing so. What this suggests, by direct inference, is the existance of a fundamental belief on Blair’s part that the state has an absolute and overarching right to know the full identity of each of its citizens and of any individual within its borders at all times and in all circumstances.

This, as should be obvious, is a fundamental inversion of the relationship between the state and its citizens; one in which the state ceases to derive its existance and authority from a social contract in which the citizen voluntarily cedes certain privileges and authorities to the states (such as monopoly on the use of force/violence within its bounds) in return for state acting to preserve the citizen’s rights, freedoms and liberties and affording the citizen a measure of security from external and internal threat and becomes, instead, a discrete entity in its own right with its own inalienable rights and entitlements outside of any social contract and derived from its very existance and from its ‘ownership’ of monopoly on the use of force/violence, which it may exercise irrespective of the wishes of its citizenry.

The former condition, in which the state is defined and bound by a social contract, is a hallmark of democracy, the latter of a feudal monarchy or totalitarian regime in which the state is exclusive tool of the ruling elite and not a servant of the people.

None of this should come as any particular surprise, as this view of state as an entity distinct from its citizenry has been a consistant sub-text of much of government policy in recent years and, indeed, animates the entire ‘rights -vs- responsibilities’ debate the the present government has sought to initiate and sustain on each and every occasion upon which events have conspired to afford them the opportunity.

In this 2005 article from the Guardian, Blair deploys what has been, for some time, one of his favourite canards, that of seeking to recast the parameters of the debate in terms of conflicting ‘liberties’ in which the state is portrayed as defending that which, in his opinion, is the most important.

But this is not a debate between those who value liberty and those who do not. It is an argument about the types of liberties that need to be protected given the changing nature of the crimes that violate them. And it is an attempt to protect the most fundamental liberty of all - freedom from harm by others.

In that same article, in which he defends the introduction of anti-social behaviour orders, Blair incorporates a reference to the supposed ‘balancing’ of citizens’ rights and responsbilities…

However, it wasn’t just a question of matching legal rights with legal responsibilities. It was about changing the legal processes by which such rights and responsibilities are determined.

This being a more or less direct reference to a programme of change first set out by Blair in 2002, in the following manner:

With these new opportunities come responsibility. The street crime initiative, for example, has been one of the most successful partnerships between government and the police in living memory. But the truth is people don’t feel more secure and they know the system is not yet working as it should. It has become inceasingly clear what the problem with the system is:

· A nineteenth-century criminal justice system trying to solve twenty-first-century crimes;

· Too little joined-up working between police, CPS and other agencies;

· Too little focus on the hard core of persistent offenders who commit more than half the crime;

· Court procedures that are cumbersome;

· Justice weighted towards the criminal and in need of rebalancing towards the victim;

· Police not freed up and given the flexibility to focus on the crime and antisocial behaviour;

· Punishment that often does not fit the severity of the crime.

So this autumn we will focus on tackling these problems. We are pursuing radical reform of the Criminal Justice System, tackling anti-social behaviour and restoring social cohesion to fragmented communities.

What makes these articles both interesting and revealing is, first, that Blair consciously recasts the duty of the state to afford its citizen’s a measure of security in terms of its being both a right and a fundamental liberty, rather than a contractual obligation from which the state derives, in part, its legitimacy, and second, in setting out the framework for what he calls ‘reponsibilities’, Blair set out a programme ciouched exclusively in terms of defining and augmenting the power of the state to enforce those ‘responsibilities’ on its citizenry, which, by extension, recasts these reponsibilities in the form of their being the citizen’s duties to the state and not the responsibilities of citizens towards each other, this being a particular nasty fiction promulgated by Blair on the back of complete misreading of Isaiah Berlin’s ‘Two Concepts of Liberty’.* [see endnote]
In doing so, Blair is implicitly overturning the fundamental basis of the social contract, which far from being an arrangement between citizen and state entered into voluntarily and for the mutual benefit of both parties, has now become a coercive arrangement under which the state no longer derives legitimacy by means of preserving the rights and securing the liberties of its citizens and affording them a measure of security necessary to facilitate their unfettered enjoyment of both but rather offers protection to its subjects in return for the performance of certain duties of benefit to the state and for which the state will apply sanctions (and exercise its monopoly over the use of force/violence) should its subject seek to demur.

Britain may well possess all the trappings and outward signs of a democracy, but these do not serve the purpose for which they are intend, which is to periodically effect the renewal of the social contract and afford the state its legitimacy, rather they serve only to apply a thin veneer of respectability to what is, otherwise, little more than a large-scale protection racket, as can be seen most clearly, here, in his Telegraph article:

It was also very clear from last week’s arguments about surveillance and the DNA database that the public, when anyone bothers to ask them, are overwhelmingly behind CCTV being used to catch or deter hooligans, or DNA being used to track down those who have committed horrific crimes. And that’s what surveys suggest, too, about their position on ID cards. 

ID cards, a DNA database, CCTV and the rapidly developing ‘database state’ being, of course, the price that Blair seeks to exact in return for the state’s protection.

…

Endnote.

By way of irony, Blair wrote to Berlin shortly before the latter’s death in 1997 in an effort to debate with Berlin both his ‘Two Concepts of Liberty’ and more generally the way forward for ‘the left’ following the demise of Soviet-style state ’socialism’, and in his letter made the following observations.

The brief discussion in the interview of the relationship between your two concepts of liberty is, I think, illuminating. The limitations of negative liberty are what have motivated generations of people to work for positive liberty, whatever its depradations [sic] in the Soviet model. That determination to go beyond laissez-faire continues to motivate people today. And it is in that context that I would be interested in your views on the future of the Left.

And

As you say, the origins of the Left lie in opposition to arbitrary authority, intolerance and hierarchy. The values remain as strong as ever, but no longer have a ready made vehicle to take them forward. 

Berlin was, sadly, too ill to reply and died shortly after receiving Blair’s letter, which was prompted by a reprint in Prospect of an interview given by Berlin to Stephen Lukes soem five years previous - a fact that Prospect neglected to mention at the time.

One cannot help but wonder, in the circumstances, quite waht Berlin might have made of Blair, both then and now, when it has become entirely apparent both that Blair has long since abandoned the values of opposition to arbitrary authority, intolerance and hierarchy that he professed, at the time, to be as strong as ever having sat for ten years at the apex of the British political hierarchy and become, in that time, the very epitome of arbitrary authority, and that Blair has entirely vindicated Berlin’s critique of ‘positive liberty’ in which he argued that it politically dangerous because it afforded the political elite a justification for curtailing the ‘negative liberties’ of citizen’s ‘for their own good’ by conducting himself in just such a fashion.